Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942012000100013
Brazilian Journal of Anesthesiology
Special Article

Bloqueio do nervo supraescapular: procedimento importante na prática clínica

Suprascapular nerve block: important procedure in clinical practice

Marcos Rassi Fernandes; Maria Alves Barbosa; Ana Luiza Lima Sousa; Gilson Cassem Ramos

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Resumo

JUSTIFICATIVA E OBJETIVOS: A dor no ombro é uma queixa frequente que ocasiona grande incapacidade funcional no membro acometido, assim como redução na qualidade de vida dos pacientes. O bloqueio do nervo supraescapular é um método terapêutico eficaz e vem sendo cada vez mais utilizado pelos anestesiologistas tanto para anestesia regional quanto para analgesia pós-operatória de cirurgias realizadas nesta articulação, o que justifica a presente revisão, cujo objetivo principal é descrever a técnica aplicada e as indicações clínicas. CONTEÚDO: Apresenta-se a anatomia do nervo supraescapular, desde a sua origem do plexo braquial até os seus ramos terminais, assim como as características gerais e a técnica empregada na execução do bloqueio deste nervo, as principais drogas utilizadas e o volume e as situações em que se faz jus a sua aplicação. CONCLUSÕES: O bloqueio do nervo supraescapular é um procedimento seguro e extremamente eficaz na terapia da dor no ombro. Também de fácil reprodutibilidade, está sendo muito utilizado por profissionais de várias especialidades médicas. Quando bem indicado, este método deve ser considerado

Palavras-chave

ANATOMIA, DOR, Crônica, TÉCNICAS ANESTÉSICAS, Bloqueio Regional

Abstract

BACKGROUND AND OBJECTIVES: Shoulder pain is a frequent complaint that results in great functional disability in the affected shoulder as well as the decrease in patients' quality of life. Suprascapular nerve block is an effective therapeutic method and has been increasingly used by anesthesiologists both for regional anesthesia and postoperative analgesia of surgeries carried out in this articulation, which justifies this review, whose main purpose was to describe the applied technique and clinical indications. CONTENT: It is presented the anatomy of suprascapular nerve, since its brachial plexus origin until its terminal branches, as well as general characteristics and technique employed to carry out the block of this nerve, main drugs used, volume and situations that give rise to its applications. CONCLUSIONS: Suprascapular nerve block is a safe and extremely effective procedure in shoulder pain therapy. It also has an easy reproducibility and has been very used by professionals of many medical specialties. When it is well-indicated, this method must be taken into consideration

Keywords

ANESTÉSICOS, Anesthesia, Conduction, Shoulder Pain, Anatomy, Regional, Anesthetics, ANESTÉSICOS

References

Allen ZA, Shanahan EM, Crotty M. Does suprascapular nerve block reduce shoulder pain following stroke: a double-blind randomized controlled trial with masked outcome assessment. BMC Neurology. 2010;10:83-87.

Fernandes MR, Fernandes RJ. Artroscopia no tratamento da tendinite calcária refratária do ombro. Rev Bras Ortop. 2010;45:53-60.

Taskaynatan MA, YIlmaz B, Ozgul A. Suprascapular nerve block versus steroid injection for non- specific shoulder pain. Tohoku J Exp Med. 2005;205:19-25.

Fredrickson MJ, Krishnan S, Chenz CY. Postoperative analgesia for shoulder surgery: a critical appraisal and review of current techniques. Anaesthesia. 2010;65:608-624.

Tan N, Agnew NM, Scawn ND. Suprascapular nerve block for ipsilateral shoulder pain after thoracotomy with thoracic epidural analgesia: a double-blind comparison of 0.5% bupivacaine and 0.9% saline. Anesth Analg. 2002;94:199 -202.

Matsumoto D, Suenaga N, Oizumi N. A new nerve block procedure for the suprascapular nerve based on a cadaveric study. J Shoulder Elbow Surg. 2009;18:607-611.

Fernandes MR, Fernandes RJ. Descompressão artroscópica indireta do cisto espinoglenoidal com neuropatia do supraescapular: relato de dois casos e revisão da literatura. Rev Bras Ortop. 2010;45:306-311.

Shanahan EM, Smith MD, Wetherall M. Suprascapular nerve block in chronic shoulder pain: are the radiologists better?. Ann Rheum Dis. 2004;63:1035-1040.

Helayel PE, Conceição DB, Conceição MJ. Atitudes de anestesiologistas e médicos em especialização em anestesiologia dos CET/ SBA em relação aos bloqueios nervosos dos membros superior e inferior. Rev Bras Anestesiol. 2009;59:332-340.

Wertheim HM, Rovenstine EA. Suprascapular nerve block. Anesthesiology. 1941:541-545.

Dahan THM, Fortin L, Pelletier M. Double blind randomized clinical trial examining the efficacy of bupivacaine suprascapular nerve blocks in frozen shoulder. The Journal of Rheumatology. 2000;27:1464-1469.

Checcucci G, Allegra A, Bigazzi P. A new technique for regional anesthesia for arthroscopic shoulder surgery based on a suprascapular nerve block and an axillary nerve block: an evaluation of the first results. Arthroscopy. 2008;24:689-696.

Vorster W, Lange CPE, Briet RJP. The sensory branch distribution of the suprascapular nerve: An anatomic study. J Shoulder Elbow Surg. 2008;17:500-502.

Barber FA. Suprascapular nerve block for shoulder arthroscopy. Arthroscopy. 2005;21(1015):e1-1015.e4.

Checchia SL, Fregoneze M, Miyazaki AN. Tratamento da capsulite adesiva com bloqueios seriados do nervo supra-escapular. Rev Bras Ortop. 2006;41:245-252.

Dangoisse MJ, Wilson DJ, Glynn CJ. MRI and clinical study of an easy and safe technique of suprascapular nerve blockade. Acta Anaesthesiol Belg. 1994;45:49-54.

Shanahan EM, Ahern M, Smith M. Suprascapular nerve block (using bupivacaine and methylprednisolone acetate) in chronic shoulder pain. Ann Rheum Dis. 2003;62:400-406.

Karatas GK, Meray J. Suprascapular nerve block for pain relief in adhesive capsulitis: comparison of 2 different techniques. Arch Phys Med Rehabil. 2002;83:593-597.

Singelyn FJ, Lhotel L, Fanre B. Pain relief after arthroscopic shoulder surgery: a comparison of intraarticular analgesia, suprascapular nerve block, and interscalene brachial plexus block. Anesth Analg. 2004;99:589-592.

Price DJ. The shoulder block: a new alternative to interscalene brachial plexus blockade for the control of postoperative shoulder pain. Anaesth Intensive Care. 2007;35:575-581.

Wassef MR. Suprascapular nerve block a new approach for the management of frozen shoulder. Anaesthesia. 1992;47:120-124.

Meier G, Bauereis C, Maurer H. The modified technique of continuous suprascapular nerve block: A safe technique in the treatment of shoulder pain. Anaesthesist. 2002;51:747-753.

Feigl GC, Anderhuber F, Dorn C. Modified lateral block of the suprascapular nerve: a safe approach and how much to inject? A morphological study. Reg Anesth Pain Med. 2007;32:488-494.

Jerosch J, Saad M, Greig M. Suprascapular nerve block as a method of preemptive pain control in shoulder surgery. Knee Surg Sports Traumatol Arthrosc. 2008;16:602-607.

Favejee MM, Huisstede BMA, Koes BW. Frozen shoulder: the effectiveness of conservative and surgical interventions-systematic review. Br J Sports Med. 2011;45:49-56.

Neal JM, McDonald SB, Larkin KL. Suprascapular nerve block prolongs analgesia after nonarthroscopic shoulder surgery but does not improve outcome. Anesth Analg. 2003;96:982-986.

Boonsong P, Jaroenarpomwatana A, Boonhong J. Preliminary study of suprascapular nerve block (SSNB) in hemiplegic shoulder pain. J Med Assoc Thai. 2009;92:1669-1674.

Nilsson J, Madeja M, Elinder F. Bupivacaine blocks N-Type inactivating Kv channels in the open state: no allosteric effect on inactivation kinetics. Biophys J. 2008;95:5138-5152.

Harmon D, Hearty C. Ultrasound-guided suprascapular nerve block technique. Pain Physician. 2007;10:743-746.

Schneider-Kolsky ME, Pike J, Connell DA. CT-guided suprascapular nerve blocks: a pilot study. Skeletal Radiol. 2004;33:277-282.

Borglum J, Bartholdy A, Hautopp H. Ultrasound-guided continuous suprascapular nerve block for adhesive capsulitis: one case and a short topical review. Acta Anaesthesiol Scand. 2011;55:-247.

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